The present state of the art involves anoscopes that are used in hemorrhoidal surgery. Anoscopes are conical-tipped cylindrical devices that are inserted into rectum through the anus by the help of the conical tip that enlarges the anal canal and are advanced in rectum up to a particular distance. The handle, a part of the anoscope that remains outside the body, is used to rotate the anoscope 360 degrees inside the rectum.
In the state of the art, some anoscopes have a cavity in their handles into which a light source can be inserted. Thus, the inner part of the anoscope becomes more visible. Such an anoscope has been the subject of the European patent application numbered EP1183991.
Anoscopes with adequately large hole diameters through which devices for surgical interventions can be inserted have been subjects of the above-mentioned European patent application EP1183991; the USA patent applications US20060036129 and US20030130559; and the Japanese patent application JP2003235799.
Although the hole diameter of the anoscope mentioned in the International patent application WO2004064624 is small, it is possible to ligate vessels of the hemorrhoids through a window which is placed near the tip of the anoscope.
In the state of the art, some anoscopes have constant hollow diameters like that mentioned in the U.S. Pat. No. 6,142,933. Upper part of some of these anoscopes is totally open, while some anoscopes, like that mentioned in the USA patent application US20060009797, have wide longitudinal slots. Hemorrhoids that fill these slots can be removed surgically.
Anoscope-resembling cylindrical anal retractors mentioned in the U.S. Pat. No. 5,681,265 have variable inner hollow diameter, however a light source can not be inserted into their handles. Furthermore, performing the procedure of stapled hemorrhoidopexy is not possible using these retractors. The anoscope mentioned in the U.S. Pat. No. 6,142,933 has a constant hole diameter and an open top, and has been planned for the application of a purse string suture to rectum. However, hemorrhoids hanging down from this open top block the vision thereby making it difficult to put a purse string suture to rectum.
For the present applications of the technique, surgical interventions cannot be performed using anoscopes with small inner diameters. Although suturing is possible through the window placed at the tip of the anoscope mentioned in the International patent application WO2004064624, this anoscope can not be used for surgical removal of hemorrhoids, for putting purse string suture to rectum and for stapled hemorrhoidopexy.
None of the anoscopes in the present state of the art are suitable for insertion of a laparoscope and none of them have an adjustable sliding lid that covers the open top of the anoscope. Besides, the above-mentioned anoscopes cannot be used for controlling staple line and they do not allow surgical interventions as necessary.